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Set up electronic claim/RA file sharing

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires that all health care providers and payers must use the X12 5010 version to exchange EDI business data.

Page last updated on: 6/25/26

Electronic data interchange (EDI) setup

We accept ANSI X12 EDI files through a direct connection with Clearinghouses that use Secure File Transfer Protocol (SFTP). 

Companion guides

Priority Health doesn't publish companion guides, as we strictly adhere to HIPAA standards. Refer to Products I X12.

Registration forms

Electronic Remittance Advice (835)

To receive the 835 payment/remittance advice electronically for dates of service on / before Aug. 31, 2026, complete this form by Aug. 31.

For dates of service starting Sept. 1, 2026, we're working with Optum Financial (Optum) and ECHO Health Inc (ECHO) to provide payment and payment reconciliation services to our provider network. To receive the 835 payment/remittance advice electronically for dates of service starting Sept. 1, 2026, you can either complete the form linked above by Aug. 31, and we'll securely share your clearinghouse information with Optum. Alternatively, you may choose to sign up for 835s with Optum only by completing the ERA portion of ECHO's online enrollment form.

Transaction types available for EDI

  • 270, Eligibility requests, batch and real time
  • 271, Eligibility responses, batch and real time
  • 276, Claim status requests, batch and real time
  • 277, Claim status responses, batch and real time
  • 277CA, Claim acknowledgment
  • 278, Authorizations
  • 834, Member enrollment
  • 835, Payment/Remittance advice
  • 837P and 837I, Claims
  • 999, Functional acknowledgements

Real-time transaction exceptions

Eligibility and claim status transactions are both available 24/7, with these exceptions:

  • Regularly scheduled maintenance periods, which occur on the second weekend of each month.
  • Non-routine downtime periods, which are published a week in advance.
  • Unscheduled downtime periods, which are communicated within an hour directly to clearinghouses and/or trading partners who utilize real time services.

Questions / Updating your EDI setup

Have questions? Need to change your EDI setup?

  • Contact ECHO Provider Support / Card Services at 833.202.5918 for questions related to 835 setup for dates of service starting Sept. 1, 2026.
  • Contact our EDI team via email at edisetup@priorityhealth.com for any other EDI-related questions.